Does the ChOLE classification relate to the duration of surgery?

Introduction: Cholesteatoma, a challenging entity in otologic surgery, necessitates a standardized classification system for effective communication among healthcare providers and consistent reporting of surgical outcomes. The ChOLE Classification System, introduced by Linder et al., stages cholesteatoma based on extension (Ch), ossicular chain status (O), life-threatening complications (L), and Eustachian tube function and mastoid pneumatization (E).

Methods: We classified 199 patients who underwent cholesteatoma surgery between 2019 and 2023 in our University Hospital to assess the distribution of the ChOLE stages and to examine the relationship between the ChOLE stages and the duration of surgery.

Results: This study revealed significant correlations between the ChOLE stage and respective subgroups of the classification and duration of surgery and thus complexity of procedure.

Conclusion: Despite limitations, the ChOLE classification proves valuable in predicting surgical complexity and optimizing patient care. Further research is warranted to validate these findings and enhance cholesteatoma management strategies.